Individual
MICHAEL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSS, CRM
Contact information
Practice address
2045 SILVERTON RD NE STE A, SALEM, OR 97301-0100
(971) 375-3792
Mailing address
2045 SILVERTON RD NE STE A, SALEM, OR 97301-0100
(971) 375-3792
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-24-4197
OR
175T00000X
Peer Specialist
Primary
THW000004320
OR
Other
Enumeration date
05/21/2021
Last updated
07/11/2024
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